Individual
LAURA JANESE BRISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1101 N JIM DAY RD, SALEM, IN 47167-5200
(812) 650-7215
Mailing address
1101 N JIM DAY RD, SALEM, IN 47167-5200
(812) 650-7215
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
IN
Other
Enumeration date
12/20/2018
Last updated
12/20/2018
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