| NPI | 1982223764 |
|---|---|
| Former Name | TANYA AYN LINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303700) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 3407) |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2024-04-15 |