| NPI | 1700265626 |
|---|---|
| Former Name | LETISHA LYNN RANNELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 233012366) |
| Enumeration Date | 2015-05-26 |
| Last Update Date | 2015-05-26 |