| NPI | 1962830620 |
|---|---|
| Former Name | STEPHANIE BOOCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 12397) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 742) |
| Enumeration Date | 2013-10-16 |
| Last Update Date | 2024-06-14 |