| NPI | 1528475191 |
|---|---|
| Former Name | DIANE GREGORY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 1073) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 0584) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2018-02-09 |