| NPI | 1326580622 |
|---|---|
| Former Name | MADISEN COOK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-ACLC-LIC-19677) |
| Enumeration Date | 2016-11-17 |
| Last Update Date | 2021-02-03 |