| NPI | 1396395729 |
|---|---|
| Former Name | LASHUNN PATRICE WINDOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17508-130) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 3215-226) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2019-09-17 |