| NPI | 1699408955 |
|---|---|
| Former Name | BROOKE BAMBAUER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.177060) |
| Enumeration Date | 2022-07-05 |
| Last Update Date | 2022-11-29 |