NPI | 1366051344 |
---|---|
Former Name | CARRIE SORESNON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 2512) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304951) |
Enumeration Date | 2020-07-27 |
Last Update Date | 2023-10-26 |