| NPI | 1295369684 |
|---|---|
| Former Name | LORENE WILLIAMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10072) |
| Enumeration Date | 2020-02-25 |
| Last Update Date | 2020-02-25 |