| NPI | 1770155822 |
|---|---|
| Former Name | DANA MARIE DALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 301217) |
| Enumeration Date | 2021-07-16 |
| Last Update Date | 2021-07-16 |