| NPI | 1083041222 |
|---|---|
| Former Name | MADISON LODEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MS M8774) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MS M8774) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2020-05-21 |