Individual
ALEXANDRA ETONIRU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S.
Contact information
Practice address
2 SCHOOL ST, PLYMOUTH, MA 02360
(508) 555-5555
Mailing address
2 SCHOOL ST, PLYMOUTH, MA 02360
(508) 555-5555
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
09/21/2007
Last updated
12/10/2008
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