NPI | 1609462480 |
---|---|
Former Name | ANA ALICIA PEREZ-INGRAM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 59774) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 15054) |
101YM0800X Counselor, Mental Health (Licence: TX 59774) | |
Enumeration Date | 2020-12-16 |
Last Update Date | 2023-11-21 |