| NPI | 1992261119 |
|---|---|
| Former Name | MARY M ALLEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA 60779570) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-02-12 |