| NPI | 1346487782 |
|---|---|
| Former Name | MARY E THEORET |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 104142) |
| Enumeration Date | 2009-01-07 |
| Last Update Date | 2020-10-12 |