| NPI | 1922362557 |
|---|---|
| Former Name | STEPHANIE LYNNE PENICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WA MG 60261458) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2019-09-05 |