NPI | 1073148177 |
---|---|
Former Name | PAIGE SUSAN JOY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 172V00000X Community Health Worker (Licence: CA A019260615) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA A019260615) |
Enumeration Date | 2020-03-09 |
Last Update Date | 2023-08-31 |