| NPI | 1669984597 |
|---|---|
| Other Name | DEBORAH DEWALT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1268071017) |
| Enumeration Date | 2017-11-01 |
| Last Update Date | 2018-11-26 |