| NPI | 1700613437 |
|---|---|
| Former Name | BROOKE ROBERTSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA LAC-5224) |
| Enumeration Date | 2024-09-17 |
| Last Update Date | 2026-08-21 |