NPI | 1992217806 |
---|---|
Former Name | RAZA-TRIMBACH SUBRYAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14767) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NC 334180) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL 4773) | |
Enumeration Date | 2017-11-01 |
Last Update Date | 2017-11-01 |