NPI | 1689214355 |
---|---|
Former Name | STACY LYNN HUTTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2020-01-10 |
Last Update Date | 2020-01-10 |