NPI | 1285464503 |
---|---|
Former Name | HALEY MARIE PEDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA t24050) |
Enumeration Date | 2024-08-02 |
Last Update Date | 2024-08-02 |