| NPI | 1346072642 |
|---|---|
| Former Name | BARBARA LEE WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-07-19) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-21 |