| NPI | 1861951139 |
|---|---|
| Former Name | JENNIFER SUNDERLAND |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 80183) |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2023-06-21 |