NPI | 1124547708 |
---|---|
Former Name | KENDRA RHAELANA WEBSTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: LA 10549) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: LA 20180634) |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2017-09-14 |
Last Update Date | 2023-02-26 |