| NPI | 1306197397 |
|---|---|
| Former Name | AUDREY SCIANDRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6803085349) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |