| NPI | 1265571392 |
|---|---|
| Former Name | BRENDA JEAN LANGMACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 1365) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2509) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 673) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2008-07-01 |