NPI | 1407215577 |
---|---|
Former Name | FAITH ANN PAYNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-30311) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-ACLC-LIC-13362) |
1041C0700X Social Worker, Clinical (Licence: MT BBH-SWLC-LIC-32305) | |
Enumeration Date | 2016-02-18 |
Last Update Date | 2021-07-21 |