NPI | 1528474301 |
---|---|
Former Name | MOLLY RAE MARX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801096024) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16591-130) |
104100000X Social Worker (Licence: WI 129072-121) | |
Enumeration Date | 2014-07-01 |
Last Update Date | 2014-07-01 |