| NPI | 1629836424 |
|---|---|
| Former Name | ALICIA MARTIN-VEGA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17107) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2024-10-09 |