NPI | 1760726228 |
---|---|
Former Name | JEWRINE VONCILE HAROLD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10242) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2784-A) |
Enumeration Date | 2012-11-21 |
Last Update Date | 2020-04-23 |