NPI | 1124227749 |
---|---|
Former Name | KIMBERLEE DAWN CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 370045EN) |
Enumeration Date | 2007-07-13 |
Last Update Date | 2021-03-25 |