| NPI | 1710350632 |
|---|---|
| Former Name | SHANNON MARIE NUTTING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA N0810131730) |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-02 |