NPI | 1477062602 |
---|---|
Former Name | KARIE MARIE BUSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 16-04-05) |
101YM0800X Counselor, Mental Health (Licence: OR R4216) | |
Enumeration Date | 2017-09-19 |
Last Update Date | 2023-03-09 |