| NPI | 1972638633 |
|---|---|
| Former Name | JANE MARIE LINDBLOM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00001649) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2007-07-08 |