NPI | 1730555392 |
---|---|
Former Name | ELLIE M WILLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0014078) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACB.0008257) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2015-08-18 |
Last Update Date | 2023-10-26 |