NPI | 1295183952 |
---|---|
Former Name | ANGELIA R CANTWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT BBH-LCPC-LIC-46912) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-LIC-3378) |
101YP2500X Counselor, Professional (Licence: ME CC6870) | |
Enumeration Date | 2016-06-02 |
Last Update Date | 2022-10-25 |