| NPI | 1568560845 |
|---|---|
| Former Name | BRENDA CAROL THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0718000167) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: VA 0701001470) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2007-07-08 |