NPI | 1902079387 |
---|---|
Former Name | ANITA LOUISE STUART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN LPC00288) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN ADC300947) |
Enumeration Date | 2008-04-08 |
Last Update Date | 2008-04-08 |