| NPI | 1285934224 |
|---|---|
| Former Name | LISA RENEE TATGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SD CSW-PIP6277) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 006892) |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2023-10-23 |