NPI | 1265946305 |
---|---|
Former Name | NICOLE DEREESE SUTTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA-168151) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH C.1901984-TRNE) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2017-11-28 |
Last Update Date | 2019-11-01 |