| NPI | 1629231550 |
|---|---|
| Former Name | TABITHA KAISER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C007307) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1656) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2020-03-25 |