| NPI | 1245428176 |
|---|---|
| Former Name | CARRIE JEAN WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA W0501011526) |
| Enumeration Date | 2007-10-04 |
| Last Update Date | 2016-07-20 |