| NPI | 1588444681 |
|---|---|
| Former Name | TONYA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM CTB-2023-0736) |
| Enumeration Date | 2023-10-05 |
| Last Update Date | 2023-10-05 |