NPI | 1356798078 |
---|---|
Former Name | LACIE GRUNSKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CO 0001840) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACD.0001175) |
Enumeration Date | 2016-05-23 |
Last Update Date | 2020-10-07 |