| NPI | 1376948679 |
|---|---|
| Former Name | MATTRACEA WARREN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MO 2017037738) |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2014-10-29 |
| Last Update Date | 2021-05-03 |