| NPI | 1316423304 |
|---|---|
| Former Name | ALEXANDRA DELOACH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LC11395) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP9603) |
| Enumeration Date | 2018-07-13 |
| Last Update Date | 2023-03-14 |