NPI | 1598081499 |
---|---|
Former Name | EVE ROSE MANDREKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2010-04-16 |
Last Update Date | 2013-12-05 |