NPI | 1467662015 |
---|---|
Other Name | PEGGY ANN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children (Licence: NM 006277) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM T-CTL0203831) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2019-07-12 |