| NPI | 1053667634 |
|---|---|
| Former Name | JULIE WYONA PAYNE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC5190) |
| Enumeration Date | 2012-08-01 |
| Last Update Date | 2012-08-01 |