| NPI | 1033460373 |
|---|---|
| Former Name | LATONIA GRISSOM BLUE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801119307) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM M-08035) |
| Enumeration Date | 2012-09-26 |
| Last Update Date | 2026-05-11 |