NPI | 1760896880 |
---|---|
Former Name | AMBER BUNCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: KY 242649) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KY 166576) |
Enumeration Date | 2014-06-17 |
Last Update Date | 2020-10-27 |