| NPI | 1346803459 |
|---|---|
| Former Name | SHIRLEY JEAN TALBERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC CADC-20954) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2022-07-11 |