| NPI | 1467827212 |
|---|---|
| Former Name | PEGGY JEAN HARRISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 001693) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 05204) |
| Enumeration Date | 2015-12-04 |
| Last Update Date | 2015-12-04 |