NPI | 1104068329 |
---|---|
Former Name | SANDRA MARIE WINN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC 11660) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AZ LAC11923) |
Enumeration Date | 2009-04-02 |
Last Update Date | 2009-04-16 |