| NPI | 1720441470 |
|---|---|
| Former Name | EMILY ELIZABETH KOSMECKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: OR 201504087LPN) |
| Enumeration Date | 2016-03-31 |
| Last Update Date | 2023-05-10 |