| NPI | 1982143608 |
|---|---|
| Former Name | ANITA SHINKLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC0006190) |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2024-04-01 |