| NPI | 1225674922 |
|---|---|
| Former Name | SERENNA LYNN STONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 17-10-19) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2019-11-18 |