NPI | 1679873780 |
---|---|
Former Name | DESIREE C CANTORNA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NV CP0120) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 01194) |
Enumeration Date | 2010-10-25 |
Last Update Date | 2016-01-21 |