NPI | 1811388911 |
---|---|
Former Name | AMANDA MICHELLE COLLMAN-MURPHY |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-3523) |
Enumeration Date | 2015-02-10 |
Last Update Date | 2024-03-28 |