| NPI | 1467279117 |
|---|---|
| Former Name | ELIZABETH CLAIRE RADLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1984) |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |