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Individual
ALICE ROCK
Active
Individual
ALICE ROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
0710103695
VA
101YM0800X
Mental Health Counselor
Primary
00255
IA
Other
Enumeration date
04/25/2022
Last updated
04/25/2022
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