NPI | 1730898727 |
---|---|
Former Name | GRACE CASSIDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NJ 37PC00913300) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00361400) |
101YM0800X Counselor, Mental Health (Licence: NJ 37AC00554300) | |
Enumeration Date | 2022-11-17 |
Last Update Date | 2023-01-23 |