| NPI | 1356923460 |
|---|---|
| Other Name | JASMINE RENEE FAULCON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-27163) |
| Enumeration Date | 2021-04-27 |
| Last Update Date | 2021-04-27 |