| NPI | 1740054519 |
|---|---|
| Former Name | KRYSTLE HARRIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1522950823) |
| Enumeration Date | 2023-11-13 |
| Last Update Date | 2026-05-20 |