NPI | 1164541223 |
---|---|
Former Name | TARA RENEE WHITE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OH I.0900067-SUPV) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: OH S.0500486) |
Enumeration Date | 2007-03-28 |
Last Update Date | 2016-03-10 |