| NPI | 1841858800 |
|---|---|
| Former Name | GABRIELLE JOHANNA MCMANN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WV BP00945505) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV BP00945505) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2019-06-04 |