NPI | 1457610750 |
---|---|
Former Name | HEATHER HILDA KOPP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5003-123) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15625132) |
Enumeration Date | 2012-05-08 |
Last Update Date | 2023-12-04 |