NPI | 1548308919 |
---|---|
Former Name | MIRACLE RAYE HAASE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 537-9-15-05-254) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302079) |
101YM0800X Counselor, Mental Health (Licence: ND 537-9-15-05) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1507) | |
101YM0800X Counselor, Mental Health (Licence: MN 00959) | |
Enumeration Date | 2007-02-01 |
Last Update Date | 2023-02-16 |