NPI | 1275783078 |
---|---|
Former Name | DENISE SIMONE MEDLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C007478) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW10498) |
Enumeration Date | 2008-09-29 |
Last Update Date | 2013-03-14 |