NPI | 1134374747 |
---|---|
Former Name | CRISTAL ROSE GERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904011150) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA RC60063009) |
Enumeration Date | 2008-11-24 |
Last Update Date | 2022-09-08 |