NPI | 1558402321 |
---|---|
Former Name | STELLA EUBANKS VAN GUILDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701002500) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000088) |
106H00000X Marriage & Family Therapist (Licence: VA 0717000699) | |
Enumeration Date | 2007-02-12 |
Last Update Date | 2007-07-08 |