| NPI | 1295275824 |
|---|---|
| Former Name | STEPHANIE COLEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 73528) |
| Enumeration Date | 2017-03-01 |
| Last Update Date | 2026-01-29 |