| NPI | 1366272874 |
|---|---|
| Former Name | DEBRA KAY CARPENTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303074) |
| Enumeration Date | 2024-08-07 |
| Last Update Date | 2024-08-07 |