| NPI | 1720497118 |
|---|---|
| Former Name | MARY J BRICE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 9381-123) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15798-132) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2020-03-16 |