NPI | 1134528789 |
---|---|
Former Name | KAITLIN ALLEY MACDONALD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121571) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 222047) |
Enumeration Date | 2014-08-20 |
Last Update Date | 2019-07-17 |