NPI | 1023318045 |
---|---|
Former Name | REGINA KINGMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 26712) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: LA 4526) |
Enumeration Date | 2010-10-25 |
Last Update Date | 2022-01-27 |