| NPI | 1114456506 |
|---|---|
| Former Name | COURTNEY LANE CHINN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 253597) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: KY 7366) |
| Enumeration Date | 2017-06-08 |
| Last Update Date | 2022-07-21 |