Individual
MADELINE VANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0704011642
VA
101YA0400X
Addiction (Substance Use Disorder) Counselor
0709023932
VA
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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