| NPI | 1487110243 |
|---|---|
| Former Name | TERI JEAN GIANNA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A057470620) |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2021-10-06 |