NPI | 1952490799 |
---|---|
Former Name | MARY JANE BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0005087) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000254) |
Enumeration Date | 2006-10-12 |
Last Update Date | 2024-07-25 |