| NPI | 1750072377 |
|---|---|
| Former Name | VANNA HAITHCOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.183522) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.183522) |
| Enumeration Date | 2023-05-16 |
| Last Update Date | 2023-11-17 |