| NPI | 1114245305 |
|---|---|
| Former Name | JEANNE DEVO FAIR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 1022) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 2534) |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2019-10-22 |