| NPI | 1912225061 |
|---|---|
| Former Name | CARLA A GRUNDHAUSER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-43588) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ND 5318) |
| Enumeration Date | 2010-05-13 |
| Last Update Date | 2021-03-05 |