NPI | 1235454869 |
---|---|
Former Name | LILLIAN CARMEN GUTHRIE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: NC 3931) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS 2354) |
Enumeration Date | 2010-04-07 |
Last Update Date | 2015-12-18 |