| NPI | 1518083120 |
|---|---|
| Former Name | LACEY JEAN FLECKENSTEIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1577) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-07-01 |