NPI | 1154308419 |
---|---|
Former Name | MARY K TRENT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8260) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MN 10287) |
Enumeration Date | 2005-12-28 |
Last Update Date | 2023-11-03 |