| NPI | 1750905295 |
|---|---|
| Former Name | THERESA MCGINNIS MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2020-06-01 |
| Last Update Date | 2020-10-26 |