NPI | 1477959666 |
---|---|
Former Name | SHELLY BAYLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2014-11-14 |
Last Update Date | 2016-01-28 |