NPI | 1174959969 |
---|---|
Former Name | TRINA B. DAVIS-FORTUNE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904008281) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 16-703) |
1041C0700X Social Worker, Clinical (Licence: TN 6602) | |
1041C0700X Social Worker, Clinical (Licence: FL TPSW1435) | |
Enumeration Date | 2013-09-24 |
Last Update Date | 2022-04-14 |