| NPI | 1528561156 |
|---|---|
| Former Name | JENNIFER LOWE CLARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL 3072G) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-03-09 |