| NPI | 1548413859 |
|---|---|
| Former Name | CAROL THAYER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 5758) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC-6699) |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2010-07-26 |