NPI | 1164541827 |
---|---|
Former Name | CHRISTINE LEE DECREW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 5563) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 618) |
Enumeration Date | 2007-03-27 |
Last Update Date | 2021-04-06 |