| NPI | 1689979106 |
|---|---|
| Former Name | LA'TANYA WILLIAMS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-0821) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2011-01-13 |