| NPI | 1871010652 |
|---|---|
| Former Name | JAN CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH CDCA.161629) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2017-08-23 |