NPI | 1205201860 |
---|---|
Former Name | ROMELL HICKERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101Y00000X Counselor |
103K00000X Behavior Analyst | |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2015-12-08 |
Last Update Date | 2019-10-10 |