NPI | 1790455665 |
---|---|
Former Name | LINDSEY R JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: PA PC010440) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PA 9736) |
Enumeration Date | 2021-09-14 |
Last Update Date | 2021-09-23 |