| NPI | 1215537477 |
|---|---|
| Former Name | HANNAH MAE FORNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 303758) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |