| NPI | 1649393711 | 
|---|---|
| Former Name | CAROL DIANE PARKER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA CCS-13034)  | 
| Enumeration Date | 2007-04-06 | 
| Last Update Date | 2016-11-17 |