NPI | 1073030037 |
---|---|
Former Name | BRITTANY BAKENHASTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: OH C1700153) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.130665) |
Enumeration Date | 2017-08-29 |
Last Update Date | 2022-01-28 |