NPI | 1023705472 |
---|---|
Former Name | STEPHANIE NICOLE POWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-29054) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 26562) |
Enumeration Date | 2023-04-18 |
Last Update Date | 2025-03-25 |