| NPI | 1942798533 |
|---|---|
| Former Name | MARTINE COLEPAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10511) |
| Additional Taxonomies | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: MA 18011) |
| Enumeration Date | 2018-04-29 |
| Last Update Date | 2023-11-02 |