| NPI | 1205984523 |
|---|---|
| Other Name | ELIZABETH DIANE SALLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A020560815) |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2019-06-06 |