NPI | 1801261284 |
---|---|
Former Name | ERICA ECKENSBERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA PRIMARY) |
Enumeration Date | 2015-12-10 |
Last Update Date | 2015-12-10 |