NPI | 1205685542 |
---|---|
Former Name | KRISTA LEE KLADDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
Additional Taxonomies | 1041C0700X Social Worker, Clinical |
Enumeration Date | 2024-05-17 |
Last Update Date | 2024-08-14 |