| NPI | 1740941160 |
|---|---|
| Former Name | STEPHANIE MALAINE MASTERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-01-07 |
| Last Update Date | 2022-01-07 |