NPI | 1942353438 |
---|---|
Former Name | KIMBERLY J MANIERO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 4694) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 4694) |
Enumeration Date | 2007-01-19 |
Last Update Date | 2022-01-15 |