NPI | 1619421880 |
---|---|
Former Name | BREANNE BERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: MI 6801101631) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801101631) |
Enumeration Date | 2016-08-05 |
Last Update Date | 2019-05-01 |