| NPI | 1770148116 |
|---|---|
| Former Name | RANDI LYNN BROKAW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.171903) |
| Enumeration Date | 2019-05-01 |
| Last Update Date | 2025-04-15 |