NPI | 1194864686 |
---|---|
Former Name | AMANDA ELAINE WRAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: RI ISW01691) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 113201) |
Enumeration Date | 2007-02-05 |
Last Update Date | 2017-11-13 |