NPI | 1922303445 |
---|---|
Former Name | JANA MARIE MATHEWSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG60131241) |
Additional Taxonomies | 101Y00000X Counselor (Licence: WA CO60146808) |
Enumeration Date | 2011-01-13 |
Last Update Date | 2019-08-06 |