NPI | 1659954022 |
---|---|
Former Name | GRETA RENEE WILLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 21-CRM-562) |
Additional Taxonomies | 175T00000X Peer Specialist |
Enumeration Date | 2021-05-03 |
Last Update Date | 2025-04-04 |