NPI | 1790928703 |
---|---|
Former Name | DIANA BUSH BARBEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK #37) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: OK L0021002) |
Enumeration Date | 2009-04-07 |
Last Update Date | 2009-04-07 |