| 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 |