| NPI | 1639726557 |
|---|---|
| Former Name | PAULA MARIE SIMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18888-130) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-08-26 |