NPI | 1134514102 |
---|---|
Former Name | WENDILYN ALMA BAILEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401014569) |
Enumeration Date | 2015-04-06 |
Last Update Date | 2015-04-06 |