| NPI | 1821483108 | 
|---|---|
| Former Name | ALLIETA ANDERSON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 26985) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1127) | 
| Enumeration Date | 2015-04-02 | 
| Last Update Date | 2023-03-28 |