NPI | 1265907448 |
---|---|
Former Name | BIANCA LANA BURRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 007374) |
Additional Taxonomies | 104100000X Social Worker (Licence: GA 007957) |
Enumeration Date | 2018-10-04 |
Last Update Date | 2024-04-05 |