| NPI | 1346986759 |
|---|---|
| Former Name | CARRIE RUDD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17027-132) |
| Enumeration Date | 2022-05-09 |
| Last Update Date | 2023-12-18 |