| NPI | 1437719978 |
|---|---|
| Former Name | CHARLEANER NICHOLE TERRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2021-04-05 |