NPI | 1205009354 |
---|---|
Former Name | LILLIAN M BENAVIDES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 7502-125) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1965-132) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11226-135) | |
Enumeration Date | 2008-04-09 |
Last Update Date | 2020-03-03 |