| NPI | 1780206425 |
|---|---|
| Former Name | JEANETTE A BECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 001263) |
| Enumeration Date | 2020-05-16 |
| Last Update Date | 2020-06-01 |