| NPI | 1447518766 |
|---|---|
| Former Name | JENNA FARIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001118A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IN 33006338A) |
| Enumeration Date | 2012-04-24 |
| Last Update Date | 2015-10-27 |