NPI | 1417485210 |
---|---|
Former Name | AMBER DAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 71456) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12565) |
Enumeration Date | 2017-05-24 |
Last Update Date | 2024-10-30 |