NPI | 1417917246 |
---|---|
Former Name | HEIDI N JACOBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C1694) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 990318) |
Enumeration Date | 2006-03-24 |
Last Update Date | 2022-05-06 |