NPI | 1104174036 |
---|---|
Former Name | MONICA PHELPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P016479) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS20224) |
Enumeration Date | 2012-08-27 |
Last Update Date | 2022-07-08 |