| NPI | 1568720472 |
|---|---|
| Former Name | MARISSA ELIZABETH MACIAS BIRD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 8173984-6004) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: UT 8173984-6004) |
| 101Y00000X Counselor (Licence: UT 8173984-6004) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 8173984-6004) | |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2016-04-25 |