NPI | 1609334184 |
---|---|
Former Name | JENNIFER ANGELYN BRADLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: WI 130712-121) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 20446) |
Enumeration Date | 2019-03-04 |
Last Update Date | 2023-11-22 |