NPI | 1740725787 |
---|---|
Former Name | MARTHA JO ACTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-3329) |
Enumeration Date | 2016-12-29 |
Last Update Date | 2016-12-29 |