NPI | 1437768132 |
---|---|
Former Name | QUINCY EILEEN FRAETIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 172V00000X Community Health Worker (Licence: CA 9657) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA 9657) |
Enumeration Date | 2020-07-28 |
Last Update Date | 2023-06-29 |