NPI | 1881279578 |
---|---|
Former Name | ASHLEA MEGAN WOLF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5172) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 16-10-16) |
Enumeration Date | 2021-03-14 |
Last Update Date | 2021-03-14 |