| NPI | 1619449576 |
|---|---|
| Former Name | STEPHANIE MARIE SIMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15364) |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2023-03-24 |