| NPI | 1144451246 |
|---|---|
| Former Name | MARY ANN MANSUETO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC4380) |
| Enumeration Date | 2009-08-06 |
| Last Update Date | 2009-08-06 |