| NPI | 1396196846 |
|---|---|
| Former Name | KELLI CHASE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22735) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2018-08-01 |