NPI | 1013626316 |
---|---|
Former Name | KATIE ELIZABETH HODGES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-22-2055) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: OR 24-QMHA-R-5809) |
Enumeration Date | 2022-11-16 |
Last Update Date | 2024-11-26 |