NPI | 1255440343 |
---|---|
Former Name | STEPHANIE FELISA MORA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 3385) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 93) |
Enumeration Date | 2006-08-30 |
Last Update Date | 2011-01-07 |