NPI | 1326382557 |
---|---|
Former Name | LAUREN DORNELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 9301) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC #9301) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-2834) | |
101YM0800X Counselor, Mental Health (Licence: NC 9301) | |
Enumeration Date | 2012-11-10 |
Last Update Date | 2017-01-23 |