| NPI | 1043763956 |
|---|---|
| Former Name | MARIE D. STAFFORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 6156-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 6156-125) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2024-03-14 |