| NPI | 1518327915 |
|---|---|
| Former Name | JACQUELINE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A017330315) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2022-02-04 |