NPI | 1972800100 |
---|---|
Former Name | MELISSA ANN HEMMESTAD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPCMH2238) |
Additional Taxonomies | 101Y00000X Counselor (Licence: SD LPCMH2238) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD LAC07111332) | |
Enumeration Date | 2011-02-24 |
Last Update Date | 2018-08-31 |