NPI | 1982196226 |
---|---|
Former Name | AMY SHAVINSKY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 93251) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 68270) |
Enumeration Date | 2018-06-01 |
Last Update Date | 2024-12-11 |