| NPI | 1265941603 |
|---|---|
| Former Name | BEVERLY MCCLANAHAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WV AP00944317) |
| Enumeration Date | 2017-09-28 |
| Last Update Date | 2022-07-21 |