NPI | 1053933176 |
---|---|
Other Name | MISTY DOLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2020-05-12 |
Last Update Date | 2023-08-09 |