| NPI | 1184990780 |
|---|---|
| Former Name | TAMARA ALEXANDRA TRUSEWYCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 6678-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16038-132) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2017-10-19 |