| NPI | 1508874397 |
|---|---|
| Former Name | JACQUELYN NED |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN C-4381) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2018-09-14 |