NPI | 1497456040 |
---|---|
Former Name | KAREN LYNN CRISSEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.19954) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0002205) |
Enumeration Date | 2023-03-10 |
Last Update Date | 2023-03-10 |