| NPI | 1104675545 |
|---|---|
| Former Name | MADISON LEE ROWE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 24019) |
| Enumeration Date | 2024-05-17 |
| Last Update Date | 2024-05-17 |