NPI | 1417601584 |
---|---|
Former Name | SARA CRAIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.027408) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 36478) |
Enumeration Date | 2022-02-08 |
Last Update Date | 2024-08-15 |