| NPI | 1770887028 |
|---|---|
| Former Name | TEKIA M LONGSTREET |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 10553-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15751-131) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2024-12-02 |