NPI | 1104233709 |
---|---|
Former Name | DANIELLE DESSA STANSBERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 253257) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2014-07-15 |
Last Update Date | 2018-05-03 |