| NPI | 1487014221 |
|---|---|
| Former Name | KAREN BLIVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 08-03-44) |
| Enumeration Date | 2016-03-04 |
| Last Update Date | 2016-09-08 |