| NPI | 1780115105 |
|---|---|
| Former Name | MELANIE LYNN JENNINGS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00004773) |
| Enumeration Date | 2017-03-27 |
| Last Update Date | 2023-04-13 |