| NPI | 1922536622 |
|---|---|
| Former Name | MELISSA MARIE PURTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 78407) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0000711) |
| 101YP2500X Counselor, Professional (Licence: CO 0013368) | |
| Enumeration Date | 2017-05-25 |
| Last Update Date | 2018-03-17 |