NPI | 1215289343 |
---|---|
Former Name | BRENDEEN ALLRED LONGORIA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NV 5486-C) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: UT 6025235-3501) |
Enumeration Date | 2012-10-13 |
Last Update Date | 2016-07-17 |