| NPI | 1538935614 |
|---|---|
| Former Name | MARIAH ELIZABETH ERTAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0135740) |
| Additional Taxonomies | 104100000X Social Worker |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2025-02-14 |