NPI | 1750792065 |
---|---|
Former Name | SARAH ELIZABETH REAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10737) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC A21153) |
Enumeration Date | 2014-05-09 |
Last Update Date | 2018-07-18 |