NPI | 1194028175 |
---|---|
Former Name | LISA M PREUT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 4011) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MO 2005024750) |
Enumeration Date | 2010-12-13 |
Last Update Date | 2022-07-12 |