| 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 |