NPI | 1316294911 |
---|---|
Other Name | CARISSA C MCREYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NM X-07919) |
Additional Taxonomies | 1041S0200X Social Worker School (Licence: NM C-09929) |
Enumeration Date | 2012-08-14 |
Last Update Date | 2022-11-09 |