NPI | 1255953303 |
---|---|
Former Name | KATIE JO MICHEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C015217) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 16263) |
1041C0700X Social Worker, Clinical (Licence: TX 112762) | |
Enumeration Date | 2020-05-12 |
Last Update Date | 2025-08-22 |