NPI | 1144343872 |
---|---|
Former Name | KRISTIE ROULEAU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 481) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 547) |
Enumeration Date | 2007-04-09 |
Last Update Date | 2010-03-09 |