NPI | 1164877213 |
---|---|
Former Name | JOVANA BURDICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1228690416) |
Enumeration Date | 2016-04-26 |
Last Update Date | 2021-06-22 |