| NPI | 1265917652 |
|---|---|
| Former Name | MARIE CHOQUETTE MACCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60272965) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA 60436297) |
| Enumeration Date | 2018-10-01 |
| Last Update Date | 2018-10-01 |