NPI | 1831265420 |
---|---|
Former Name | ANGELA WHITECRANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1162-LAC) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 603) |
Enumeration Date | 2006-11-27 |
Last Update Date | 2007-07-08 |