NPI | 1083189617 |
---|---|
Former Name | KATRINA SUZANNE MELTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2018-10-10 |
Last Update Date | 2024-12-16 |