| NPI | 1417403551 |
|---|---|
| Other Name | STANASIA LENISE DIXON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 15802) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2024-09-14 |