NPI | 1467531673 |
---|---|
Former Name | COLLEEN LYNETTE CORMANY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E-0003471-SUPV) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 001398) |
Enumeration Date | 2006-11-06 |
Last Update Date | 2012-01-20 |