NPI | 1972057503 |
---|---|
Former Name | JEANNETTE KISER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180010834) |
Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178011014) |
Enumeration Date | 2016-08-11 |
Last Update Date | 2022-02-18 |