NPI | 1902632771 |
---|---|
Former Name | JESSICA STUART |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME CAC8844) |
Enumeration Date | 2024-09-10 |
Last Update Date | 2024-09-10 |