| NPI | 1104338805 |
|---|---|
| Former Name | SYD LOU WAHLSTROM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: CA 112863) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 112863) |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2023-05-26 |