| NPI | 1588432512 |
|---|---|
| Former Name | KRISTIE SHERI RUSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 16675) |
| Enumeration Date | 2023-12-19 |
| Last Update Date | 2023-12-19 |