NPI | 1033633219 |
---|---|
Former Name | HALEY SHAE MAYNARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: KY 254621) |
Additional Taxonomies | 104100000X Social Worker (Licence: KY 252654) |
1041C0700X Social Worker, Clinical (Licence: KY 254621) | |
Enumeration Date | 2017-07-31 |
Last Update Date | 2023-11-08 |