NPI | 1750078572 |
---|---|
Former Name | LAURA CHRISTINE DIMITT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16046) |
Enumeration Date | 2023-04-21 |
Last Update Date | 2023-09-25 |