| NPI | 1780197657 |
|---|---|
| Former Name | TERRA FANNIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2606931) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LICDC.162297) |
| Enumeration Date | 2017-11-14 |
| Last Update Date | 2026-04-13 |