| NPI | 1043639594 |
|---|---|
| Former Name | VICTORIA MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2014001621) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 2124) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 7366) | |
| 101YP2500X Counselor, Professional (Licence: NE 2124) | |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2019-02-26 |