| NPI | 1063905305 |
|---|---|
| Former Name | KATELYN MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2021011527) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MO 2018015466) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-04-25 |