NPI | 1982078382 |
---|---|
Former Name | BRANDY K ODENWELDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA MSW008124) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA C0245) |
Enumeration Date | 2015-11-23 |
Last Update Date | 2019-05-21 |