| NPI | 1316651789 |
|---|---|
| Former Name | ELIZABETH JEAN AMELIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 108529) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC C001593) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 59885) | |
| Enumeration Date | 2023-01-10 |
| Last Update Date | 2023-02-23 |