| NPI | 1417418914 |
|---|---|
| Former Name | MONICA SIMONSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 33773) |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2019-03-27 |