| NPI | 1962228585 |
|---|---|
| Former Name | STACEY BECKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00335700) |
| Enumeration Date | 2024-11-27 |
| Last Update Date | 2024-11-27 |