| NPI | 1912436833 |
|---|---|
| Former Name | STARLA MARIE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 304663) |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2020-01-03 |