| 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 |