NPI | 1720348535 |
---|---|
Former Name | KENYON T WASHINGTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 66995) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 66995) |
Enumeration Date | 2012-05-26 |
Last Update Date | 2012-05-26 |