| NPI | 1760930481 |
|---|---|
| Former Name | AMANDA MARIE DAVEE LOMAX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 22183) |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2016-09-12 |