NPI | 1679993877 |
---|---|
Former Name | KERI LYNN WIMBERLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001136A) |
Enumeration Date | 2014-04-27 |
Last Update Date | 2014-04-27 |