| NPI | 1366263071 |
|---|---|
| Former Name | BROOKLYN NICOLE AMBUEHL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-72921) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-70324) |
| Enumeration Date | 2024-10-24 |
| Last Update Date | 2024-10-24 |