| NPI | 1104232800 |
|---|---|
| Former Name | JESSICA LENZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16009-132) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2016-04-28 |