NPI | 1124577721 |
---|---|
Former Name | ROSALIE MACKE GORDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L10298) |
Additional Taxonomies | 104100000X Social Worker |
Enumeration Date | 2016-09-25 |
Last Update Date | 2023-09-21 |