| NPI | 1457718504 |
|---|---|
| Former Name | WANDA LEE-ANN WEED |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA C13381214) |
| Enumeration Date | 2016-01-20 |
| Last Update Date | 2020-07-17 |