NPI | 1154560456 |
---|---|
Former Name | ROBIN L WISE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC0012164) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD0000241) | |
Enumeration Date | 2009-02-10 |
Last Update Date | 2017-02-15 |