NPI | 1134725203 |
---|---|
Former Name | NICOLE WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH 2103195) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2020-12-04 |
Last Update Date | 2022-10-28 |