| NPI | 1821624016 |
|---|---|
| Former Name | VANESSA GRAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 2113775) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 13775-R) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2025-08-11 |