| NPI | 1114024692 |
|---|---|
| Former Name | JUANITA LOUISE BERNARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TN LSW0000004313) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TN 4313) |
| Enumeration Date | 2006-09-19 |
| Last Update Date | 2022-06-13 |