| NPI | 1821536806 |
|---|---|
| Former Name | REGINA GILLESPIE MAILLOUX |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA 8517) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1574) |
| 101YM0800X Counselor, Mental Health (Licence: GA 8651) | |
| 251S00000X (Licence: LA 1574) | |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2022-02-04 |