NPI | 1043922461 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: GA 26-4603737) |
Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
Enumeration Date | 2022-12-16 |
Last Update Date | 2022-12-16 |