NPI | 1538357983 |
---|---|
Former Name | ANGELA L CHILDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC008999) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 6111907) |
Enumeration Date | 2007-10-11 |
Last Update Date | 2024-04-11 |