| NPI | 1205246139 |
|---|---|
| Former Name | VANESSA RAULSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 009408) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2022-10-22 |