NPI | 1417225699 |
---|---|
Former Name | LEEANN PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2011-12-02 |
Last Update Date | 2015-08-12 |