| NPI | 1417313677 |
|---|---|
| Other Name | SHELLEY EILEEN ENQUIST/BLAKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 17-10-21) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2023-09-18 |