| NPI | 1598193203 |
|---|---|
| Former Name | ASHLEY TENILLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 5149) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2013-10-16 |