| NPI | 1326304734 |
|---|---|
| Former Name | DIANE KATHRYN RANDALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A05190315) |
| Enumeration Date | 2012-04-10 |
| Last Update Date | 2024-04-18 |