NPI | 1669705018 |
---|---|
Former Name | CHARLENE MICHELLE NEGUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4025) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 12-12-79U) |
Enumeration Date | 2009-09-16 |
Last Update Date | 2023-11-29 |