| NPI | 1770947913 |
|---|---|
| Former Name | MARY ELLEN WHITE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH S.1500518) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH S.1500518) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |