| NPI | 1649805904 |
|---|---|
| Former Name | FALLON HEFFERNAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2022-08-09 |