| NPI | 1427572569 |
|---|---|
| Former Name | HEATHER GRAHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 7603-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16533-132) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2022-07-21 |