NPI | 1013543339 |
---|---|
Former Name | REBEKAH DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-43993) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-63796) |
Enumeration Date | 2020-03-18 |
Last Update Date | 2023-09-15 |