| NPI | 1225569338 |
|---|---|
| Former Name | TABATHA JO CARSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW-44878) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LMSW-36530) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2024-09-05 |