| NPI | 1003312463 |
|---|---|
| Former Name | JENNIFER NICOLE GORETCKI |
| Entity Type | Individual |
| Gender | Female |
| 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 |