| NPI | 1255963765 |
|---|---|
| Former Name | SAMANTHA MENARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI CDP00754) |
| Enumeration Date | 2020-02-12 |
| Last Update Date | 2025-10-17 |