| NPI | 1952024416 |
|---|---|
| Former Name | NICOLE ELIZABETH ELLIOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2024-10-01 |