| NPI | 1356555601 |
|---|---|
| Former Name | JULIE RENEE ROBERTSON OR BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 4417) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL 0018) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2024-02-21 |