NPI | 1144840398 |
---|---|
Former Name | COTY BENTLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801113997) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801106340) |
Enumeration Date | 2020-04-17 |
Last Update Date | 2023-11-30 |