| NPI | 1366798464 |
|---|---|
| Former Name | SHANDA KATHERINE SLAGHT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LSAT 12049) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2012-07-26 |