| NPI | 1306902747 |
|---|---|
| Former Name | TERI NEW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12192-134) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY 1540-132) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2012-08-15 |