NPI | 1699091694 |
---|---|
Other Name | JEANNINE LAVONNE DANDRIDGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 48018) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LAC21081) |
207QA0401X Family Medicine, Addiction Medicine (Licence: AZ 48018) | |
Enumeration Date | 2010-04-15 |
Last Update Date | 2025-08-27 |