| NPI | 1093155566 |
|---|---|
| Former Name | SARA LIGHT JEFFERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LPC-3973) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 10073) |
| Enumeration Date | 2013-06-28 |
| Last Update Date | 2013-06-28 |