| 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 |