| NPI | 1417528514 |
|---|---|
| Former Name | COLTE GRIDER DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34008845A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001645A) |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2021-07-08 |