NPI | 1275087587 |
---|---|
Former Name | VANESSA MEDRANO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61566335) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2016-08-04 |
Last Update Date | 2024-05-30 |