NPI | 1386817476 |
---|---|
Former Name | ANNA LEE BURBACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0012721) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 7370) |
Enumeration Date | 2008-04-09 |
Last Update Date | 2015-11-06 |