NPI | 1407056351 |
---|---|
Former Name | AMY E KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0014528) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 129) |
101YP2500X Counselor, Professional (Licence: KS 2108) | |
Enumeration Date | 2007-07-19 |
Last Update Date | 2018-07-10 |