| NPI | 1457356214 |
|---|---|
| Former Name | JULIA LOUISE WEIDLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004930A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001292A) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2014-08-18 |