| NPI | 1679923320 |
|---|---|
| Former Name | SHELLY BILBY-LOGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 6888) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2018-09-13 |