| NPI | 1649533001 |
|---|---|
| Former Name | JULIE NICOLE BOUGTAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD ADT542) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2016-08-25 |