| NPI | 1922193531 |
|---|---|
| Former Name | TINA MARIE LORENZEN-WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1822) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NE 1822) |
| 101YP2500X Counselor, Professional (Licence: NE 1218) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2021-08-27 |