NPI | 1104311745 |
---|---|
Former Name | MARGARET MARIE LONGMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: IL 149.022225) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 34557) |
Enumeration Date | 2018-06-26 |
Last Update Date | 2020-05-23 |