| NPI | 1164693990 |
|---|---|
| Former Name | LAURA FITZGERALD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2008-03-19 |
| Last Update Date | 2008-03-19 |