NPI | 1962545038 |
---|---|
Former Name | DIANE HINES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 5139) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 4079) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2007-07-08 |