NPI | 1154009520 |
---|---|
Former Name | EMILY RENEE TINGEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P019520) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-29250) |
Enumeration Date | 2023-07-06 |
Last Update Date | 2024-05-28 |