| NPI | 1275363228 |
|---|---|
| Former Name | SHAWNELL TOLLIVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2024-08-05 |
| Last Update Date | 2024-08-05 |