| NPI | 1700236718 |
|---|---|
| Former Name | STEPHANIE MUTCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ID IBADDCC/CADC #10310) |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |