| NPI | 1881777308 |
|---|---|
| Former Name | SUSAN ADELE KVIKSTAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: SD CCDC3950962) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SD LPCMH2072) |
| Enumeration Date | 2006-10-21 |
| Last Update Date | 2007-07-08 |