NPI | 1104254127 |
---|---|
Former Name | SHANA LYNCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA ASW120269) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2013-10-30 |
Last Update Date | 2024-11-12 |