NPI | 1124388418 |
---|---|
Former Name | KARA WALLACE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 104100000X Social Worker |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
Enumeration Date | 2012-05-21 |
Last Update Date | 2023-07-02 |