| 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 |