| NPI | 1528570371 |
|---|---|
| Former Name | REGINA MICHELLE WHITTLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 3359) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2017-11-02 |