NPI | 1124056460 |
---|---|
Former Name | LORI ANNETTE COFFEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005967A) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000744A) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2016-07-07 |