NPI | 1811540396 |
---|---|
Former Name | TAYLOR JO CONDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2019-07-23 |
Last Update Date | 2023-09-06 |