| NPI | 1780682898 |
|---|---|
| Former Name | CARRIE MARIE REDMOND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY LAT-323) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WY LPC-1148) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2020-07-14 |