NPI | 1093034548 |
---|---|
Former Name | CONNIE LORRAINE GARRISON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401001985) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-01837) |
101YS0200X Counselor, School (Licence: MI SC0000595) | |
Enumeration Date | 2010-05-24 |
Last Update Date | 2011-02-09 |