| NPI | 1073211843 |
|---|---|
| Former Name | JEANETTE L SUMNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 23105) |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-02-21 |