| NPI | 1467968735 |
|---|---|
| Former Name | LEA RAE MIDDLETON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.141046) |
| Enumeration Date | 2017-12-21 |
| Last Update Date | 2021-05-10 |