NPI | 1124159371 |
---|---|
Former Name | KORENEE MARIANNA WEBSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C010545) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
1041C0700X Social Worker, Clinical (Licence: VA 0904008766) | |
Enumeration Date | 2007-03-08 |
Last Update Date | 2024-10-15 |