| NPI | 1922496066 |
|---|---|
| Former Name | MARY RODGERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 6631-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17350-130) |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2014-12-23 |
| Last Update Date | 2023-12-10 |