| NPI | 1134750318 |
|---|---|
| Former Name | SUMMER RAE MAHLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-ACLC-LIC-37821) |
| Enumeration Date | 2020-01-28 |
| Last Update Date | 2020-01-28 |