| NPI | 1598063257 |
|---|---|
| Former Name | ALYSSA M WELLENS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15653-132) |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2019-12-04 |