| NPI | 1447032230 |
|---|---|
| Former Name | ASHLEY BULLARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CTB-2023-0843) |
| Enumeration Date | 2023-10-17 |
| Last Update Date | 2025-02-12 |