| NPI | 1609412519 |
|---|---|
| Former Name | LISA WALDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2025-02-15 |