| NPI | 1497293500 |
|---|---|
| Former Name | AUTUMN BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 247000000X Technician, Health Information |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2024-01-25 |