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 |