NPI | 1093931156 |
---|---|
Former Name | JUDY KAY MCKIM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 1650) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: KS 14-473382-12) |
Enumeration Date | 2007-04-17 |
Last Update Date | 2008-01-25 |