NPI | 1902316227 |
---|---|
Former Name | ROBIN KONETZKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 104100000X Social Worker (Licence: WI 128991-121) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15989-132) |
1041C0700X Social Worker Clinical (Licence: WI 8918-123) | |
Enumeration Date | 2017-10-02 |
Last Update Date | 2022-12-20 |