NPI | 1235666405 |
---|---|
Former Name | COLLEEN DORIS KLEINBERG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW020178) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA ASW68862) |
Enumeration Date | 2017-05-18 |
Last Update Date | 2023-02-15 |