| NPI | 1215284526 |
|---|---|
| Former Name | COURTNEY VASTINE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 60560) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OH S.1200950) |
| 104100000X Social Worker (Licence: TX 60560) | |
| Enumeration Date | 2012-08-07 |
| Last Update Date | 2023-04-07 |