| NPI | 1457895534 |
|---|---|
| Former Name | SASHAWNA ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: MA RN2279616) |
| Enumeration Date | 2016-12-08 |
| Last Update Date | 2016-12-08 |