| NPI | 1659841260 |
|---|---|
| Former Name | TAMMY LEE BAUER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60604747) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2018-11-27 |