| NPI | 1093023517 |
|---|---|
| Former Name | KELLEY ANNE WHITTAKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 121289) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CT 8448) |
| Enumeration Date | 2010-09-17 |
| Last Update Date | 2020-07-23 |