NPI | 1154751816 |
---|---|
Former Name | CASSIE EIDEM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA LCS 26889) |
Additional Taxonomies | 104100000X Social Worker (Licence: MN AP13-1551) |
Enumeration Date | 2013-11-16 |
Last Update Date | 2013-11-16 |