| NPI | 1881986180 |
|---|---|
| Former Name | NICOLE LYNN THORSTAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ND 4464) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 20235) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2020-09-08 |