| NPI | 1073893392 |
|---|---|
| Former Name | KATRINA DAHL WILBURN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801097572) |
| Additional Taxonomies | 104100000X Social Worker |
| 225400000X Rehabilitation Practitioner | |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2019-06-10 |