| NPI | 1952918088 |
|---|---|
| Former Name | ALLI VANESSA TELLEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001507) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0015785) |
| Enumeration Date | 2020-09-23 |
| Last Update Date | 2022-01-06 |