| NPI | 1669027926 |
|---|---|
| Former Name | SHANNON LYNN GENZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TN 972) |
| Enumeration Date | 2019-08-05 |
| Last Update Date | 2023-11-27 |