| NPI | 1558865113 |
|---|---|
| Former Name | KELLY MICHELLE DENTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.165462) |
| Enumeration Date | 2018-03-20 |
| Last Update Date | 2018-03-20 |