| NPI | 1144768417 |
|---|---|
| Former Name | LEASETTE MARIE CONWAY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NM C-11733) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NM X-10715) |
| 104100000X Social Worker (Licence: NM M-10562) | |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2021-08-30 |