| NPI | 1316105695 |
|---|---|
| Former Name | THERESA MICHEL HUSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 2878) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO 15108) |
| Enumeration Date | 2008-05-23 |
| Last Update Date | 2008-05-23 |