| NPI | 1861717597 |
|---|---|
| Former Name | JUDITH ANN CLARK BROOME |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI F854398) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI F854398) |
| Enumeration Date | 2010-04-06 |
| Last Update Date | 2010-04-06 |