| NPI | 1578807319 |
|---|---|
| Former Name | TINA RANE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 246QL0900X Spec/Tech, Pathology, Laboratory Management | |
| 251E00000X Home Health | |
| Enumeration Date | 2012-11-17 |
| Last Update Date | 2023-05-26 |