NPI | 1285985812 |
---|---|
Former Name | BERENA DYAN SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 129132) |
Additional Taxonomies | 221700000X Art Therapist (Licence: NY 001240) |
Enumeration Date | 2012-09-22 |
Last Update Date | 2025-03-19 |