NPI | 1003323445 |
---|---|
Former Name | BETHANY MICHELLE SOLOMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-20774) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-155248) |
101Y00000X Counselor (Licence: TX 79520) | |
101Y00000X Counselor (Licence: NV CP5567-R) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15017) | |
Enumeration Date | 2018-01-08 |
Last Update Date | 2024-02-20 |