| NPI | 1912960204 |
|---|---|
| Former Name | PAMELA BOLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701001146) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 106H00000X Marriage & Family Therapist (Licence: VA 0717000489) | |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2008-06-12 |