NPI | 1649649203 |
---|---|
Former Name | STEPHANIE CARLIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0015274) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000889) | |
Enumeration Date | 2015-09-24 |
Last Update Date | 2023-12-21 |