NPI | 1104281922 |
---|---|
Former Name | KARLA FISHER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2016033333) |
Additional Taxonomies | 104100000X Social Worker (Licence: MO 2014029522) |
Enumeration Date | 2015-12-21 |
Last Update Date | 2022-07-26 |