Back to Results
First PageMeta Content
Psychiatry / Clinical psychology / Alcohol / Behavior / Substance use disorder / Drug addiction / Substance dependence / Alcoholism


Intake Questionnaire Account Information Name: (Last)__________________(First)________________(Middle)______________ Address: (Street)_________________________________________________________ (City)______________________
Add to Reading List

Document Date: 2010-03-14 10:49:32

Open Document

File Size: 34,61 KB

Share Result on Facebook

Facility

Northland Therapy Center / /

IndustryTerm

mental health services / e.g. food / /

Organization

Northland Therapy Center / Division of Labor / /

Position

Physician / /

SocialTag