| NPI | 1366913204 |
|---|---|
| Former Name | MISTY AMBER COCHRAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WV 2376) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710103104) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WV 2376) | |
| 101YM0800X Counselor Mental Health (Licence: WV 2376) | |
| 101YM0800X Counselor Mental Health (Licence: VA 0701007545) | |
| 101YP2500X Counselor Professional (Licence: VA 0701007545) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2020-05-19 |