NPI | 1629056098 |
---|---|
Former Name | MARION PERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10135) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 4204) |
101YM0800X Counselor, Mental Health (Licence: RI MHC00067) | |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI LCDP00058) | |
Enumeration Date | 2006-01-05 |
Last Update Date | 2019-01-03 |