NPI | 1033460373 |
---|---|
Former Name | LATONIA GRISSOM BLUE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: NM M-08035) |
Additional Taxonomies | 1041S0200X Social Worker, School (Licence: NM M-08035) |
Enumeration Date | 2012-09-26 |
Last Update Date | 2020-08-25 |