NPI | 1255867214 |
---|---|
Former Name | AMANDA DEFURIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00583800) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37lc00314500) |
101YM0800X Counselor, Mental Health (Licence: NJ 37pc00583800) | |
Enumeration Date | 2017-05-11 |
Last Update Date | 2022-02-23 |