| NPI | 1598253890 |
|---|---|
| Former Name | CONNIE RAE GEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18546) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3265) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2018-04-23 |