| NPI | 1659847424 |
|---|---|
| Former Name | SARAH WISDOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A046801117) |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2020-10-22 |