| NPI | 1124566203 |
|---|---|
| Former Name | JOLENE CARTER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2016020574) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149012089) |
| Enumeration Date | 2017-02-08 |
| Last Update Date | 2017-09-25 |