NPI | 1386895902 |
---|---|
Former Name | LAURA MARIE HAGEBUSCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 3165) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 0) |
101YM0800X Counselor, Mental Health | |
1041C0700X Social Worker, Clinical (Licence: IA 101976) | |
1041C0700X Social Worker, Clinical (Licence: KS 11783) | |
Enumeration Date | 2008-10-01 |
Last Update Date | 2023-01-13 |