NPI | 1003256280 |
---|---|
Former Name | KAITLYN W PERCIVAL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCSW76285) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW37076) |
101YM0800X Counselor, Mental Health (Licence: CA ASW #37076) | |
Enumeration Date | 2013-07-02 |
Last Update Date | 2021-07-30 |