| NPI | 1063897809 |
|---|---|
| Former Name | RIANNON LYNN JEFFERY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2049) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-1334) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2018-12-03 |