NPI | 1023489333 |
---|---|
Former Name | TARA PRADKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 098679) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801098078) |
Enumeration Date | 2015-10-13 |
Last Update Date | 2024-01-05 |