NPI | 1649459058 |
---|---|
Former Name | MYCAH ERIN CHRISTIANSEN/DVORAK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60176350) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60900332) |
Enumeration Date | 2007-11-01 |
Last Update Date | 2019-08-23 |