NPI | 1144661778 |
---|---|
Former Name | PAMELA LORENE FOUST |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34003296A) |
Additional Taxonomies | 104100000X Social Worker (Licence: IN 1282264) |
Enumeration Date | 2013-07-11 |
Last Update Date | 2013-07-11 |