| NPI | 1093839425 |
|---|---|
| Former Name | MARY ANNE STOREY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12492-131) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 484-125) |
| 1041C0700X Social Worker, Clinical (Licence: WI 2119-123) | |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2007-07-08 |