NPI | 1053663914 |
---|---|
Former Name | GAY CLARK ANEPOHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 011030) |
101YM0800X Counselor, Mental Health (Licence: TX 011030) | |
Enumeration Date | 2012-10-02 |
Last Update Date | 2012-10-02 |