| 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 |