| NPI | 1467952713 |
|---|---|
| Former Name | JESSICA RUTH MEADOWS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-1550) |
| Enumeration Date | 2018-02-13 |
| Last Update Date | 2018-02-13 |