NPI | 1639265085 |
---|---|
Former Name | DERONDA VYNETTE KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2006-10-05 |
Last Update Date | 2018-09-19 |