NPI | 1245440866 |
---|---|
Former Name | LAURA MICHELLE WILMOTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW14615) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 12856) |
Enumeration Date | 2007-05-23 |
Last Update Date | 2023-07-25 |