| NPI | 1356886204 |
|---|---|
| Former Name | NICOLE BRENNEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH15132) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 100016) |
| Enumeration Date | 2017-01-02 |
| Last Update Date | 2021-02-08 |