| NPI | 1710424791 |
|---|---|
| Former Name | VIVIAN MENA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA C7591214) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2024-11-26 |