| NPI | 1134725872 |
|---|---|
| Former Name | HEATHER M BRANSOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 14284) |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2021-07-02 |