NPI | 1477822971 |
---|---|
Former Name | BROOKE MARIE BOUCHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA s87458415) |
Enumeration Date | 2011-12-29 |
Last Update Date | 2011-12-29 |