NPI | 1194093617 |
---|---|
Former Name | GRETCHEN EMILY JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 008154) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: TX 53319) |
Enumeration Date | 2011-12-12 |
Last Update Date | 2022-10-24 |