| NPI | 1679940027 |
|---|---|
| Former Name | MARYAM FATERIOUN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17144) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 129495) |
| Enumeration Date | 2015-09-01 |
| Last Update Date | 2024-08-22 |