NPI | 1245395011 |
---|---|
Other Name | PEGGY GRADY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 4468) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM 0114391) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0105881) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 899) | |
Enumeration Date | 2006-12-22 |
Last Update Date | 2014-01-02 |