| NPI | 1750928347 |
|---|---|
| Former Name | DANIELLE MARIE LACOST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 8297-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16520-131) |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2024-06-30 |