NPI | 1770223216 |
---|---|
Former Name | TANYA RIGGS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 8452) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 20227) |
Enumeration Date | 2022-03-31 |
Last Update Date | 2023-12-18 |