NPI | 1346542651 |
---|---|
Former Name | SUZANNE LYNETTE POWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RW3659) |
Enumeration Date | 2010-11-19 |
Last Update Date | 2010-11-19 |