NPI | 1497188858 |
---|---|
Former Name | JENNIFER ULLAKKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L5767) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 08-08-05) |
1041C0700X Social Worker, Clinical (Licence: WA LW 60297208) | |
Enumeration Date | 2013-08-20 |
Last Update Date | 2019-02-04 |