| NPI | 1811515919 |
|---|---|
| Former Name | JENNIFER LYNN MONTIEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1374141219) |
| Enumeration Date | 2020-07-06 |
| Last Update Date | 2024-12-06 |