| NPI | 1164017448 |
|---|---|
| Former Name | KATIE TALLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.026549) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IL 150.104931) |
| Enumeration Date | 2021-03-08 |
| Last Update Date | 2024-02-09 |