| NPI | 1699112532 |
|---|---|
| Former Name | CODY GOLTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12651) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 5950) |
| 101YM0800X Counselor, Mental Health (Licence: FL IMH 9990) | |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2022-08-31 |