| NPI | 1760821391 |
|---|---|
| Former Name | KAYLA JOY BAUMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1696) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2015-08-06 |