| NPI | 1225149339 |
|---|---|
| Former Name | GLENDA SUE OVERACRE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 96-04-98) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-10 |