| NPI | 1639183346 |
|---|---|
| Former Name | MARY PATRICIA WYMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 5048) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 6300) |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2011-01-05 |