NPI | 1255602330 |
---|---|
Former Name | TERESA BULLOCK VEVERKA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 104100000X Social Worker (Licence: OR A4507) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2012-01-20 |
Last Update Date | 2019-06-24 |