| NPI | 1447218987 |
|---|---|
| Former Name | CAROL L ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1799) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1799132) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2007-07-08 |