| NPI | 1124527817 |
|---|---|
| Former Name | JOHANNA LEE HABERLING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00003763) |
| Enumeration Date | 2018-02-07 |
| Last Update Date | 2018-02-07 |