NPI | 1679302699 |
---|---|
Former Name | VICTORIA LYNN REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61561982) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2024-07-29 |
Last Update Date | 2024-07-29 |