| NPI | 1861087439 |
|---|---|
| Former Name | KRISTINA L FONTAINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 23-08-20313) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR 22-QMHA-I-003390) |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2024-05-31 |