NPI | 1083184436 |
---|---|
Former Name | STARLA RACHELLE SCHROCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1627) |
Enumeration Date | 2018-11-28 |
Last Update Date | 2018-11-28 |