NPI | 1093927907 |
---|---|
Other Name | GENEVA M. WALLACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 1118L) |
Additional Taxonomies | 104100000X Social Worker (Licence: NV 00561-A) |
106H00000X Marriage & Family Therapist (Licence: NV R05387) | |
Enumeration Date | 2007-05-04 |
Last Update Date | 2007-07-08 |