| NPI | 1972753564 |
|---|---|
| Former Name | LISA LYNN SEXTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 178.003182) |
| Enumeration Date | 2008-09-19 |
| Last Update Date | 2008-09-19 |