| NPI | 1548654031 |
|---|---|
| Former Name | TAWNYA BAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 16-02-19) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 93-1200332) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2022-04-27 |