NPI | 1366822868 |
---|---|
Former Name | LILARIE THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5060) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL 11203) |
Enumeration Date | 2015-06-01 |
Last Update Date | 2015-06-01 |