NPI | 1356743371 |
---|---|
Former Name | SAMANTHA ROSE MCNAMARA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801096820) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-03159) |
Enumeration Date | 2014-09-22 |
Last Update Date | 2024-09-26 |