| NPI | 1528688504 |
|---|---|
| Former Name | BREANNE FAUVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP61278775) |
| Enumeration Date | 2020-04-20 |
| Last Update Date | 2023-12-04 |