| NPI | 1316523749 |
|---|---|
| Former Name | MANDY MARIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TX 79060) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15052) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-10-14 |