| NPI | 1598944886 |
|---|---|
| Former Name | PAMELA M. VICSIK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000416) |
| Enumeration Date | 2007-11-02 |
| Last Update Date | 2023-02-03 |