NPI | 1972878338 |
---|---|
Former Name | JENNA LEANN KRUEGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4589) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OR R3309) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 13-12-23) | |
Enumeration Date | 2012-03-19 |
Last Update Date | 2021-12-27 |