NPI | 1871211136 |
---|---|
Former Name | TAMMY GILSTRAP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 13802) |
Enumeration Date | 2022-08-22 |
Last Update Date | 2023-02-07 |