| NPI | 1184963902 |
|---|---|
| Other Name | TAKIYA KAJUAN GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG60965821) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IN 34006655A) |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2019-10-11 |