NPI | 1952765422 |
---|---|
Former Name | TAMI LYNN DORNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 73108) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 12812) |
Enumeration Date | 2016-04-11 |
Last Update Date | 2018-06-13 |