| NPI | 1992681530 | 
|---|---|
| Former Name | TINA LOUISE GAGNON | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A065680225) | 
| Enumeration Date | 2025-08-11 | 
| Last Update Date | 2025-08-11 |