NPI | 1194341651 |
---|---|
Former Name | DEBRA ANN HIDINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005579) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000268) |
Enumeration Date | 2020-06-22 |
Last Update Date | 2020-06-22 |