| NPI | 1750803383 |
|---|---|
| Former Name | KATREACE KATRELL SUMRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP00006362) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2019-09-04 |