| NPI | 1891004206 |
|---|---|
| Other Name | AMBER MARIE WIDENOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH2201) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 004204-1) |
| Enumeration Date | 2010-10-03 |
| Last Update Date | 2018-07-02 |