NPI | 1336688431 |
---|---|
Former Name | LIA CORYN LAVASSAUR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17273) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 003719-2014) |
101YP2500X Counselor, Professional (Licence: PA PC009337) | |
Enumeration Date | 2017-02-22 |
Last Update Date | 2025-04-08 |