| NPI | 1871211136 |
|---|---|
| Former Name | TAMMY GILSTRAP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 13802) |
| Enumeration Date | 2022-08-22 |
| Last Update Date | 2023-02-07 |