| NPI | 1285847624 |
|---|---|
| Former Name | ANGIE MYREE HEAROD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 958) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2019-12-20 |