| NPI | 1073155081 |
|---|---|
| Former Name | VICTORIA LYNNE HINES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA Aii060320818) |
| Enumeration Date | 2019-10-10 |
| Last Update Date | 2019-10-10 |