| NPI | 1063486447 |
|---|---|
| Former Name | KATHLEEN M. SHINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: VA 0904005283) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904005283) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2022-03-03 |