| NPI | 1356739155 |
|---|---|
| Former Name | AMY SUZANNE MARION |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC 5720) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 415) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2019-06-23 |