NPI | 1043420318 |
---|---|
Former Name | ELLEN JANELL JEFFCOAT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA cp60088744) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2013-06-07 |