NPI | 1184052375 |
---|---|
Former Name | MARY ANN COLLINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA CJP400109) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RI-E0807161445) | |
Enumeration Date | 2013-10-24 |
Last Update Date | 2013-10-24 |