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 |