NPI | 1093847790 |
---|---|
Former Name | SHAMEIKA DANIELLE LOGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 004230) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW20028) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2022-08-30 |