NPI | 1467519603 |
---|---|
Former Name | MARY BETH MCDONALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00168500) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00108700) |
Enumeration Date | 2007-01-03 |
Last Update Date | 2024-08-21 |