| NPI | 1043597958 |
|---|---|
| Former Name | ANNA RANDLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ 17271) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.007411) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 25577) | |
| Enumeration Date | 2011-11-05 |
| Last Update Date | 2024-10-07 |