NPI | 1184034050 |
---|---|
Former Name | VIVIAN LACY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW20424) |
Additional Taxonomies | 104100000X Social Worker |
222Q00000X Developmental Therapist | |
Enumeration Date | 2014-05-01 |
Last Update Date | 2024-10-22 |