NPI | 1235432055 |
---|---|
Former Name | SANDRA KAYE MABRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2010-12-16 |
Last Update Date | 2025-01-12 |