| NPI | 1679906952 |
|---|---|
| Former Name | MARINA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16033-132) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 2092) |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2016-12-06 |