| NPI | 1619490414 |
|---|---|
| Former Name | DORETHA SOMERVILLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P016624) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC lcas-26208) |
| 1041C0700X Social Worker, Clinical (Licence: NC P011845) | |
| Enumeration Date | 2017-07-24 |
| Last Update Date | 2022-09-21 |