NPI | 1295343655 |
---|---|
Former Name | DEMEISHA RICHIE JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG61090592) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60918946) |
Enumeration Date | 2020-07-21 |
Last Update Date | 2020-07-21 |