NPI | 1255830675 |
---|---|
Former Name | MELISSA ANNE BONNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WA LH61163843) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60801341) |
Enumeration Date | 2018-02-12 |
Last Update Date | 2024-09-10 |