NPI | 1164043741 |
---|---|
Former Name | KELSEY JO ZETTLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA LW61448326) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OR L14142) |
Enumeration Date | 2020-05-05 |
Last Update Date | 2024-12-09 |