| NPI | 1700547627 |
|---|---|
| Former Name | AMBER ETHENRIDGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC06296800) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ SW-GTL-20-01131) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904017456) | |
| Enumeration Date | 2022-01-03 |
| Last Update Date | 2024-10-28 |