| NPI | 1114586617 |
|---|---|
| Former Name | AMANDA KATHRYN HANNUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.2304393) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1904521) |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2023-04-07 |