NPI | 1790147890 |
---|---|
Former Name | DEBORAH WHITLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 22205) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 11549) |
Enumeration Date | 2016-03-28 |
Last Update Date | 2019-10-09 |