| NPI | 1831453968 |
|---|---|
| Former Name | MARY T. CHERULLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149007398) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 27761) |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2012-07-03 |