NPI | 1871012880 |
---|---|
Former Name | VILMA GARDNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.0011486) |
Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178.007419) |
Enumeration Date | 2017-09-12 |
Last Update Date | 2022-07-21 |