NPI | 1871844878 |
---|---|
Former Name | ALICIA MAHLSTADT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 073723) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2012-10-01 |
Last Update Date | 2019-03-26 |