| NPI | 1922581305 |
|---|---|
| Former Name | ANDREA ROSE NETTESHEIM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 61024952) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN cc01915) |
| Enumeration Date | 2018-09-11 |
| Last Update Date | 2024-06-11 |