NPI | 1710011911 |
---|---|
Former Name | SHERI LEDEBUR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6079) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 11-12-06) |
225700000X Massage Therapist (Licence: OR 5842) | |
Enumeration Date | 2007-03-16 |
Last Update Date | 2019-05-22 |