NPI | 1215274600 |
---|---|
Former Name | KAYLEE VICTORIA STIX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 084128) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 011574) |
1041C0700X Social Worker, Clinical (Licence: SC 14819) | |
Enumeration Date | 2013-01-07 |
Last Update Date | 2022-04-18 |