NPI | 1063920601 |
---|---|
Former Name | PENNY LOUISE TREICHEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 12872-R) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2018-01-17 |
Last Update Date | 2022-01-25 |