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 |