| NPI | 1154670610 |
|---|---|
| Former Name | LISA LYNN BARTHOLOMEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1686) |
| Enumeration Date | 2012-08-30 |
| Last Update Date | 2021-07-15 |