| NPI | 1659794238 |
|---|---|
| Former Name | KRISTI JO JEDLICKI LEVENHAGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 0877) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 0147) |
| Enumeration Date | 2014-02-02 |
| Last Update Date | 2014-02-02 |