NPI | 1669217618 |
---|---|
Former Name | DANIELLE MARIE SKOCILICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-55816) |
Enumeration Date | 2024-06-29 |
Last Update Date | 2024-06-29 |