NPI | 1255911194 |
---|---|
Former Name | TAMMY A START |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC ADC-2092) |
Enumeration Date | 2021-04-14 |
Last Update Date | 2021-04-26 |