NPI | 1316336779 |
---|---|
Former Name | DENISE KAREN FREDERICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CA 86754) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA ASW64732) |
Enumeration Date | 2015-01-22 |
Last Update Date | 2018-11-19 |