| NPI | 1801515002 |
|---|---|
| Former Name | CARRIE ANN MACINTOSH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 306462) |
| Enumeration Date | 2022-08-23 |
| Last Update Date | 2022-08-23 |