| NPI | 1740550581 |
|---|---|
| Former Name | LISA KAY STEVENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30044) |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2012-01-11 |