| NPI | 1619028438 |
|---|---|
| Former Name | CHRISTINA MARIE WILKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 560-126) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15179) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2007-07-08 |