NPI | 1144617671 |
---|---|
Former Name | AMANDA C. EGGERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 122091) |
Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1450732) |
104100000X Social Worker (Licence: OH I.1700060) | |
1041C0700X Social Worker, Clinical (Licence: OH 1.1700060-SUPV) | |
Enumeration Date | 2015-04-22 |
Last Update Date | 2019-10-06 |