NPI | 1104095967 |
---|---|
Other Name | SUSAN VIRGINIA BIGELOW |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 64) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2054) |
Enumeration Date | 2008-02-26 |
Last Update Date | 2013-03-19 |