NPI | 1245487149 |
---|---|
Former Name | CRYSTAL JEAN HOLMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C007363) |
Additional Taxonomies | 101Y00000X Counselor |
104100000X Social Worker (Licence: TN LSW7948) | |
1041C0700X Social Worker, Clinical (Licence: NC P005548) | |
Enumeration Date | 2008-08-21 |
Last Update Date | 2024-08-12 |