NPI | 1679817597 |
---|---|
Former Name | LATOYA CHEVELLE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 9186) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3429) |
Enumeration Date | 2012-11-15 |
Last Update Date | 2016-07-16 |