NPI | 1104194661 |
---|---|
Former Name | JULIE CHIRSTINE WILLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 838) |
Enumeration Date | 2011-12-12 |
Last Update Date | 2011-12-12 |