NPI | 1346712270 |
---|---|
Other Name | MISSI FAWN ANICE KNUST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15478) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2018-12-17 |
Last Update Date | 2021-05-05 |