| NPI | 1588406391 |
|---|---|
| Former Name | STEPHANIE LEE SELEVITCH-WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 16905-RAC) |
| Enumeration Date | 2024-06-11 |
| Last Update Date | 2024-06-26 |