| NPI | 1699247130 |
|---|---|
| Former Name | TENNILLE CHAUSSEE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00005071) |
| Enumeration Date | 2018-12-21 |
| Last Update Date | 2018-12-21 |