NPI | 1003052572 |
---|---|
Former Name | JESSICA MARIE GUTIERREZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 7533-123) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15584-132) |
Enumeration Date | 2009-01-05 |
Last Update Date | 2024-08-13 |