| NPI | 1730519570 |
|---|---|
| Former Name | ASHLEY THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12624) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP5425) |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2014-07-23 |