NPI | 1003465659 |
---|---|
Former Name | EVA BERNADETTE SORES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 14965-RAC) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
225400000X Rehabilitation Practitioner | |
Enumeration Date | 2019-09-06 |
Last Update Date | 2022-11-23 |