NPI | 1013493212 |
---|---|
Former Name | COURTNEY ANNE WELLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2021003919) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2018022860) |
Enumeration Date | 2018-07-11 |
Last Update Date | 2021-03-31 |