NPI | 1699892455 |
---|---|
Former Name | JONI LYNN DEGRADO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OH S.1802207) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OH CDCA.166938) |
101YM0800X Counselor Mental Health | |
Enumeration Date | 2007-03-24 |
Last Update Date | 2018-12-05 |