| NPI | 1619289576 |
|---|---|
| Former Name | MARY ELLEN WOMACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C1701) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 030355) |
| 101YM0800X Counselor, Mental Health (Licence: OR C1701) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2012-10-01 |