| NPI | 1851044309 |
|---|---|
| Former Name | AUTUMN TAYLOR WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.183471) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.179526) |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2023-10-02 |