| NPI | 1255646121 |
|---|---|
| Former Name | FAITHE C HANSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15899) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15630) |
| Enumeration Date | 2010-08-16 |
| Last Update Date | 2022-02-16 |