| NPI | 1649401910 |
|---|---|
| Former Name | ASHLEY ROSE SAMUELS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1609) |
| Enumeration Date | 2009-08-04 |
| Last Update Date | 2009-08-04 |