| NPI | 1023674967 |
|---|---|
| Former Name | LARISSA MORGAN GLUSZAK |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 13215) |
| Enumeration Date | 2019-05-16 |
| Last Update Date | 2019-05-16 |