| NPI | 1972289692 |
|---|---|
| Former Name | JAIME LEIGH WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1511120623) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2024-01-25 |