NPI | 1295187763 |
---|---|
Former Name | MONIQUE SORENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 12195) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 12195) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21682) | |
Enumeration Date | 2016-07-08 |
Last Update Date | 2024-04-18 |