| NPI | 1740518042 |
|---|---|
| Former Name | LAURA ANN STICKFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TN LDC0282) |
| Enumeration Date | 2009-11-24 |
| Last Update Date | 2014-02-20 |