| NPI | 1821597188 |
|---|---|
| Former Name | NYKOLE-SUSANNE LOUISE DURGIN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 175T00000X Peer Specialist |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2020-09-21 |