| NPI | 1659084713 |
|---|---|
| Former Name | CARRIE JENNINGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1437980721) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2023-01-03 |
| Last Update Date | 2023-01-03 |