| NPI | 1891264230 |
|---|---|
| Former Name | KRISTINA LYNN FAIRCHILD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH LCDCIII.162250) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2023-11-06 |