NPI | 1548670748 |
---|---|
Former Name | PATRICIA ELLEN DECKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000627) |
Enumeration Date | 2014-04-28 |
Last Update Date | 2014-04-28 |