NPI | 1114692217 |
---|---|
Former Name | TESSA KRUGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16022) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 49764) |
Enumeration Date | 2021-08-11 |
Last Update Date | 2023-02-03 |