| NPI | 1568214914 |
|---|---|
| Former Name | KERSTEN MADSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 20528-130) |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |