| NPI | 1710418314 |
|---|---|
| Former Name | SHIRLEY ANN WORTHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 2817-226) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 281728) |
| Enumeration Date | 2017-03-24 |
| Last Update Date | 2024-07-26 |