| NPI | 1093235392 |
|---|---|
| Former Name | LEANNE RADAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2025-02-28 |