| NPI | 1982793063 |
|---|---|
| Other Name | JODI LYN LIVERMON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-1101) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-12135) |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2007-07-08 |