NPI | 1154782324 |
---|---|
Former Name | EMILY M BRANTLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 071700187) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2016-03-15 |
Last Update Date | 2023-02-10 |