NPI | 1336602259 |
---|---|
Former Name | KATHRYN ANN HAEFELI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 23-07-20299) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 22-QMHA-I-003253) |
Enumeration Date | 2019-04-08 |
Last Update Date | 2024-07-24 |