NPI | 1518074749 |
---|---|
Former Name | BRENDA RAE ATWOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 1271 (LPCC)) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 006083 (LADAC)) |
Enumeration Date | 2006-08-24 |
Last Update Date | 2020-10-01 |