| NPI | 1164244174 |
|---|---|
| Professional Name | JEWELS NICOLE DATTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1505660523) |
| Enumeration Date | 2024-10-30 |
| Last Update Date | 2024-10-30 |