| NPI | 1700272754 |
|---|---|
| Former Name | JENNIFER LIPFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 8197, RASAC I) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2015-04-07 |