NPI | 1154814192 |
---|---|
Former Name | COURTNEY RAE GALLARDO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO csw.09924482) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2018-06-13 |
Last Update Date | 2022-03-29 |