| NPI | 1215334842 |
|---|---|
| Former Name | GELETTA ALLEN BALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16684-130) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |