| NPI | 1366564536 |
|---|---|
| Former Name | CARLA S DAYVAULT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000608A) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2011-04-05 |