NPI | 1790560043 |
---|---|
Former Name | STACY LIANE JONES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175T00000X Peer Specialist (Licence: CA MPSS-ICWOFK) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2023-08-25 |
Last Update Date | 2023-12-04 |