| NPI | 1679946479 |
|---|---|
| Former Name | CHARISSE MARIE CARUTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21587) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA RALR8960418) |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2020-09-30 |