NPI | 1144862061 |
---|---|
Former Name | BETH ANN HULISKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2012007523) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: KS 5216) |
Enumeration Date | 2019-10-11 |
Last Update Date | 2022-08-19 |