| NPI | 1578785812 |
|---|---|
| Former Name | MARY MARGARET KUPEC |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC1585) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 0766AD) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2007-07-08 |