| NPI | 1548289333 |
|---|---|
| Former Name | STEPHANIE WILSEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 6437) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1052) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2017-12-06 |