| NPI | 1558179291 |
|---|---|
| Former Name | TAWNY MICHELLE KEZAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA 61623928) |
| Enumeration Date | 2024-12-27 |
| Last Update Date | 2024-12-27 |