| NPI | 1407490279 |
|---|---|
| Former Name | THERESA MARIE RENDES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 10136) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2019-11-04 |
| Last Update Date | 2021-11-03 |