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 | 1041C0700X Social Worker, Clinical (Licence: NC C018302) |
1041C0700X Social Worker, Clinical (Licence: WA LW61670578) | |
222Q00000X Developmental Therapist | |
Enumeration Date | 2014-05-01 |
Last Update Date | 2025-04-30 |