| NPI | 1871723460 |
|---|---|
| Former Name | HEATHER MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MA 7984) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2015-02-24 |