| NPI | 1215541321 |
|---|---|
| Former Name | BROOKE WARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0709024366) |
| Enumeration Date | 2020-09-04 |
| Last Update Date | 2020-09-04 |