NPI | 1063132801 |
---|---|
Former Name | SHELBY COOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09930915) |
Additional Taxonomies | 104100000X Social Worker (Licence: CO SWC.0000000907) |
Enumeration Date | 2022-08-31 |
Last Update Date | 2025-01-17 |