| NPI | 1962740258 |
|---|---|
| Former Name | JODI L. FOSSUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5689-125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 1627-226) |
| Enumeration Date | 2013-01-22 |
| Last Update Date | 2017-04-26 |