| NPI | 1578047338 |
|---|---|
| Former Name | CANDICE FREESE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21982) |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2018-09-18 |