NPI | 1700238672 |
---|---|
Former Name | MELISSA L MOREAU |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC6513) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC5665) |
Enumeration Date | 2016-07-05 |
Last Update Date | 2021-09-17 |