| NPI | 1629558929 |
|---|---|
| Former Name | PATRICE MERCYNE PHILLIPS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TX 19665) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TX 7688) |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2018-08-16 |