| NPI | 1124640677 |
|---|---|
| Former Name | ELAINE PEGUERO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00314900) |
| Enumeration Date | 2020-05-07 |
| Last Update Date | 2020-05-07 |