| NPI | 1912464983 |
|---|---|
| Former Name | LAREASHA BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 77472) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 36020) |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-02-26 |