| NPI | 1275961534 |
|---|---|
| Former Name | ANGEL SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60264062) |
| Enumeration Date | 2013-10-24 |
| Last Update Date | 2022-07-21 |