NPI | 1326546771 |
---|---|
Former Name | JAN LEE TRIMBLE KILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO60781160) |
Enumeration Date | 2018-01-30 |
Last Update Date | 2018-01-30 |