NPI | 1417238379 |
---|---|
Former Name | TONIA MARIE HOLSTEN (JAMBOIS REMOVE) |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA C052360518) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA H0908201631) |
Enumeration Date | 2011-09-06 |
Last Update Date | 2020-01-31 |