NPI | 1710577002 |
---|---|
Former Name | CHRISTINA BLAZER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.121331) |
Enumeration Date | 2021-01-21 |
Last Update Date | 2021-01-21 |