| NPI | 1003292814 |
|---|---|
| Former Name | AMBER LEA MEDLIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C010991) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22213) |
| 1041C0700X Social Worker, Clinical (Licence: NC P009827) | |
| Enumeration Date | 2015-08-04 |
| Last Update Date | 2019-09-05 |