NPI | 1891099040 |
---|---|
Former Name | SHELLY WHEELER MCCOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD SC0357) |
Enumeration Date | 2011-01-03 |
Last Update Date | 2011-01-03 |