NPI | 1447518766 |
---|---|
Former Name | JENNA FARIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34007537A) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001118A) |
Enumeration Date | 2012-04-24 |
Last Update Date | 2025-02-07 |