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 |