NPI | 1295078814 |
---|---|
Former Name | RENEE DENISE RYSKAMP |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801095211) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801095211) |
Enumeration Date | 2013-04-02 |
Last Update Date | 2018-11-15 |