NPI | 1700108917 |
---|---|
Former Name | ELLENE CORACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401011779) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401011779) |
Enumeration Date | 2010-02-16 |
Last Update Date | 2014-01-02 |