| NPI | 1801021159 |
|---|---|
| Former Name | STACIE WENTLING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR A5434) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2009-05-15 |
| Last Update Date | 2025-12-02 |