| NPI | 1467937573 |
|---|---|
| Former Name | MANDY JO HERRMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1832) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-09-25 |