| NPI | 1639555758 |
|---|---|
| Former Name | KARLA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 4101006646) |
| Enumeration Date | 2015-07-31 |
| Last Update Date | 2015-07-31 |