NPI | 1205904406 |
---|---|
Former Name | RENEE BERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 104311) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904004872) |
Enumeration Date | 2006-12-04 |
Last Update Date | 2022-02-17 |