| NPI | 1801551510 |
|---|---|
| Former Name | REYNALDO STONEY BLACKRAVEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| 251B00000X Case Management | |
| Enumeration Date | 2021-11-08 |
| Last Update Date | 2024-12-22 |