| NPI | 1326030545 |
|---|---|
| Former Name | MARY M COAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 01284) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 92026) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2017-07-19 |