| 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 |