| NPI | 1194494013 |
|---|---|
| Former Name | ANGELA RENEE DEGUISE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-23-2420) |
| Additional Taxonomies | 175T00000X Peer Specialist |
| Enumeration Date | 2021-09-13 |
| Last Update Date | 2023-09-25 |