NPI | 1518461854 |
---|---|
Former Name | BRIANNA GAYLE GERDES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C016030) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-27141) |
1041C0700X Social Worker, Clinical (Licence: NC P012252) | |
Enumeration Date | 2018-03-21 |
Last Update Date | 2023-05-23 |