NPI | 1225697212 |
---|---|
Former Name | TONYA MARIE AMOUR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: ID 38735) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID 38735) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 38735) | |
Enumeration Date | 2019-06-12 |
Last Update Date | 2019-06-12 |