| NPI | 1215500343 |
|---|---|
| Former Name | CANDICE HEITZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2021-07-16 |