| NPI | 1124684451 |
|---|---|
| Former Name | KEANNA GLORIA WORTHY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA OL70024377) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: MO RBT-18-70458) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2025-07-18 |