NPI | 1689333999 |
---|---|
Former Name | ROSEMARIE OWOC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH23700) |
Additional Taxonomies | 101Y00000X Counselor |
101YA0400X Counselor, Addiction (Substance Use Disorder) | |
101YM0800X Counselor, Mental Health | |
171W00000X Contractor | |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
261QM0850X Clinic/Center, Adult Mental Health | |
261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
Enumeration Date | 2021-12-14 |
Last Update Date | 2024-04-19 |