| NPI | 1710667159 |
|---|---|
| Former Name | TABITHA N. CLAYTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 21167-130) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2026-06-12 |