NPI | 1346840766 |
---|---|
Former Name | KAREN MARIE MASIELLO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 19602) |
Enumeration Date | 2020-10-26 |
Last Update Date | 2020-10-27 |