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 |