NPI | 1326576141 |
---|---|
Former Name | HEATHER THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801119031) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI CAADC-D) |
Enumeration Date | 2017-05-24 |
Last Update Date | 2025-05-09 |