NPI | 1780974162 |
---|---|
Former Name | MELISSA DZIENGIELEWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11154) |
Enumeration Date | 2011-04-19 |
Last Update Date | 2022-12-22 |