| NPI | 1417451220 |
|---|---|
| Former Name | STEPHANIE MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 14-03-26) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |