| NPI | 1861055444 |
|---|---|
| Former Name | WYNNE LOUISE KIKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 12281) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 81228) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |