| NPI | 1346419561 |
|---|---|
| Former Name | SHELLY HODSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 3990-125) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 2620-120) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16032-132) | |
| Enumeration Date | 2008-02-21 |
| Last Update Date | 2017-01-20 |