| NPI | 1578069977 |
|---|---|
| Former Name | MARY LOUISE ORTIZ RYAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 305099) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |