| 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 |