| NPI | 1053947507 |
|---|---|
| Former Name | LISA GAIL AVELAR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP60923722) |
| Enumeration Date | 2020-03-17 |
| Last Update Date | 2020-06-10 |