NPI | 1477998334 |
---|---|
Former Name | ALINE BETHEA TALMAGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.017796) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2013-05-06 |
Last Update Date | 2018-03-17 |