NPI | 1982772893 |
---|---|
Former Name | MARY ELIZABETH LIPE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 09-09-26) |
Enumeration Date | 2006-11-30 |
Last Update Date | 2015-04-14 |