| NPI | 1215291257 |
|---|---|
| Former Name | AMANDA KAY ZIEBARTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 274) |
| Enumeration Date | 2012-06-25 |
| Last Update Date | 2012-06-25 |