NPI | 1508292061 |
---|---|
Former Name | CHARVEY MARIE DEJANAKUL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2013-09-16 |
Last Update Date | 2020-06-11 |