| NPI | 1760742522 |
|---|---|
| Former Name | ROSEMARY HETRICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16569-130) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-10-29 |