| NPI | 1407030778 |
|---|---|
| Former Name | KRISTINA PEDERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 770100966) |
| Enumeration Date | 2007-12-21 |
| Last Update Date | 2021-10-06 |