NPI | 1720359912 |
---|---|
Other Name | KAYLA MARIE WIEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1100574) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH ICDC.141029) |
Enumeration Date | 2012-01-19 |
Last Update Date | 2022-11-30 |