| NPI | 1225598063 |
|---|---|
| Former Name | RITA MARIE SURFACE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001602A) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IN 87001602A) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2020-12-01 |