NPI | 1902170996 |
---|---|
Former Name | AMANDA LEE FLEMING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0800170) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH ICDC.100327) |
Enumeration Date | 2012-03-08 |
Last Update Date | 2013-05-08 |