| NPI | 1174826168 |
|---|---|
| Former Name | DEANGELA JOI NILES NILES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 003093LPC) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA C-4506) |
| Enumeration Date | 2010-12-13 |
| Last Update Date | 2014-07-24 |