NPI | 1922491562 |
---|---|
Former Name | JULIA MARTHA WARDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC16182) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ME LC6778) |
Enumeration Date | 2015-03-06 |
Last Update Date | 2019-07-08 |