NPI | 1255165395 |
---|---|
Former Name | MICHELLE A REYES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 445c05758100) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37c00277500) |
Enumeration Date | 2024-08-30 |
Last Update Date | 2024-08-30 |