NPI | 1063701910 |
---|---|
Former Name | KENIA VIDAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37CA00071000) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 17340) |
Enumeration Date | 2011-03-31 |
Last Update Date | 2011-03-31 |