NPI | 1912127226 |
---|---|
Former Name | GRETCHEN ELIZABETH SQUIRES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 011159) |
101YP2500X Counselor, Professional (Licence: OH C 0008035) | |
Enumeration Date | 2007-04-27 |
Last Update Date | 2023-02-22 |