| NPI | 1992335616 |
|---|---|
| Former Name | AMANDA TREHERN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 001360) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2020-01-22 |