| NPI | 1134430739 |
|---|---|
| Former Name | AMBER LAURISSA BACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL ACD.0002183) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC.0007263) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2022-12-28 |