| NPI | 1952119224 |
|---|---|
| Former Name | AMANDA NICHOLE ROWE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 20661-130) |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2024-12-19 |