NPI | 1952616435 |
---|---|
Former Name | ELIZABETH ANN WHITTENBURG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801092437) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801092437) |
101YM0800X Counselor, Mental Health (Licence: MI 6801092437) | |
Enumeration Date | 2010-08-09 |
Last Update Date | 2014-01-14 |