| NPI | 1134558919 |
|---|---|
| Former Name | LAURA MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16044-132) |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2024-06-05 |