| NPI | 1346021912 |
|---|---|
| Former Name | PAIGE L PENNINGTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2023047508) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO 0015530) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 000165) | |
| Enumeration Date | 2023-10-10 |
| Last Update Date | 2023-12-01 |