| NPI | 1962953133 |
|---|---|
| Former Name | JENNIE LEE FARBER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RA858809) |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2016-10-21 |
| Last Update Date | 2022-07-21 |