NPI | 1336884147 |
---|---|
Former Name | MEREDITH RACHEL LEIGH BIRD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO LSW.0009924574) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ADDC.0000274) |
Enumeration Date | 2022-05-05 |
Last Update Date | 2023-08-09 |