NPI | 1225356843 |
---|---|
Former Name | BRIENNE KELLY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 75071) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 118764) |
Enumeration Date | 2010-05-06 |
Last Update Date | 2020-04-01 |