| NPI | 1194992669 |
|---|---|
| Former Name | AMY ELIZABETH DEWALT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL SW3798) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW3798) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2021-04-21 |