NPI | 1316001068 |
---|---|
Former Name | COLLEEN MARY SCHLENKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904007932) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: GA CSW003791) |
Enumeration Date | 2006-12-20 |
Last Update Date | 2015-07-08 |