| NPI | 1972256139 |
|---|---|
| Former Name | LAUREN N. ILLGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00736700) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00344300) |
| Enumeration Date | 2022-01-28 |
| Last Update Date | 2022-02-10 |