NPI | 1134381866 |
---|---|
Former Name | ALEXIS BURROUGHS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0052135) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000428) |
Enumeration Date | 2008-06-25 |
Last Update Date | 2019-04-23 |