| NPI | 1134636830 |
|---|---|
| Former Name | MELISSA IPPOLITO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC.0005430) |
| Enumeration Date | 2018-01-03 |
| Last Update Date | 2019-04-15 |