| NPI | 1578045589 |
|---|---|
| Former Name | TAMARA DENISE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: NC 13917) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 24268) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2021-05-10 |