NPI | 1104305259 |
---|---|
Former Name | FREDA K O' DONOGHUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61026569) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 33622) |
1041C0700X Social Worker, Clinical (Licence: IL 149.020544) | |
Enumeration Date | 2018-08-09 |
Last Update Date | 2021-04-21 |