| NPI | 1194217984 |
|---|---|
| Former Name | TAMARA ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 00000631) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2019-11-22 |