| NPI | 1972178176 |
|---|---|
| Former Name | TRACEY CHRISTENSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1595) |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |