NPI | 1770221939 |
---|---|
Former Name | ANGELA RANDOLPH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC CADC-2661) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC CADC-27410) |
Enumeration Date | 2022-05-26 |
Last Update Date | 2022-05-26 |