| NPI | 1053896506 |
|---|---|
| Former Name | BONNIE JEAN NICOLE MANNS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 251828) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2025-10-01 |