NPI | 1982274486 |
---|---|
Former Name | MIA S AHNTHOLZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NJ 44SC06151200) |
Additional Taxonomies | 104100000X Social Worker (Licence: NY 079317-01) |
104100000X Social Worker (Licence: NJ 44SL05543800) | |
Enumeration Date | 2021-06-28 |
Last Update Date | 2023-01-31 |