| NPI | 1467685891 |
|---|---|
| Former Name | STEPHANIE LYNN ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2009-09-02 |
| Last Update Date | 2014-01-22 |