| NPI | 1417102781 |
|---|---|
| Former Name | JULIE ANN STANISH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15618-130) |
| Enumeration Date | 2008-11-30 |
| Last Update Date | 2008-11-30 |