| NPI | 1194095026 |
|---|---|
| Former Name | RACHAEL CYNTHIA MAY KELLAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005656A) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904006338) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2014-02-17 |