NPI | 1003312463 |
---|---|
Former Name | JENNIFER NICOLE GORETCKI |
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 33009095A) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
1041C0700X Social Worker, Clinical (Licence: IN 33009095A) | |
Enumeration Date | 2018-04-04 |
Last Update Date | 2024-04-23 |