| NPI | 1679221733 |
|---|---|
| Former Name | DENA FREDRICKSON-WEBSTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1423670321) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2022-03-16 |