| NPI | 1962507533 |
|---|---|
| Former Name | CAROL DENISE BORN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 03026319) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2007-07-08 |