| 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 |