| NPI | 1508322884 |
|---|---|
| Former Name | TAMMY JO SAMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 23851) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2025-07-18 |