NPI | 1972955714 |
---|---|
Former Name | LAUREN EAST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC0013916) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD0000980) |
Enumeration Date | 2016-07-05 |
Last Update Date | 2019-03-29 |