| NPI | 1306263694 |
|---|---|
| Former Name | DANA MARIE VICK |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY CABIP) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |