NPI | 1720478688 |
---|---|
Former Name | NICOLE DOOZAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801108389) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801095993) |
104100000X Social Worker (Licence: MI 6801095993) | |
Enumeration Date | 2015-01-30 |
Last Update Date | 2022-02-22 |