| NPI | 1194549048 |
|---|---|
| Former Name | KASEY ANN MOWRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: RI CDP01011) |
| Enumeration Date | 2024-11-07 |
| Last Update Date | 2024-11-07 |