NPI | 1710244355 |
---|---|
Former Name | BROOKE LYERLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 8034) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1712) |
Enumeration Date | 2012-04-20 |
Last Update Date | 2017-03-02 |