NPI | 1356725162 |
---|---|
Former Name | RACHAEL ANN FREDERICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 9088) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 18118) |
Enumeration Date | 2015-07-13 |
Last Update Date | 2023-09-18 |