| NPI | 1669860383 | 
|---|---|
| Former Name | JANICE MALLARI VICEDO | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5387) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) | 
| 101YM0800X Counselor, Mental Health | |
| 372600000X Adult Companion | |
| Enumeration Date | 2015-01-05 | 
| Last Update Date | 2021-09-24 |