| NPI | 1790655041 |
|---|---|
| Former Name | KATIE KRISTINE WELLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16607-132) |
| Enumeration Date | 2025-11-10 |
| Last Update Date | 2025-11-10 |