Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | CC01968 | MN |
NPI | 1003335696 |
---|---|
Provider Name | Jade Lynn Holewinski |
First Address | Winona, MN 55987-6365 |
Second Address | Winona, MN 55987-6365 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2017 |
Last Update Date | 14/11/2018 |