NPI | 1194339978 |
---|---|
Former Name | JESSICA DRAKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904009009) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: DC LC50078761) |
Enumeration Date | 2020-08-31 |
Last Update Date | 2021-10-22 |